Identification of males at increased risk for genital human papillomavirus (HPV) infection among patients referred for urological consultation

In order to identify the probable risk groups, this study analysed the reasons for referral to a urological clinic and the indications for peniscopy among males with suspected genital HPV infection. The patients were derived from a series of 2370 consecutive males attending our urological clinic in Sao Paulo, of whom 652 males (27.5%) aroused a clinical suspicion of genital HPV infection. Patients were categorized into 7 groups, according to their indications for referral. Altogether, 459 (70.4%) were examined by peniscopy, and 403 (87.8%) were biopsied and tested for HPV by Hybrid Capture 2 (HCII) for both oncogenic and non-oncogenic HPV types. The most frequent indication for referral in HPV-positive males (both in peniscopy and by HCII) was other diseases (group 6), followed by those who had partners HPV positive (group 1). The highest HPV prevalence (42%) was found among those with visible lesions, followed by those (38%) with previous condyloma. Of the other STDs, urethritis was significantly associated with HPV detection. Importantly, HPV was detected in 27% of the males referred due to other conditions non-related to HPV. We conclude that the risk groups for genital HPV infections include males with visible lesions, previous history of condyloma, those with HPV-positive partners, recurrent balanitis, as well as those with other STDs. Urethritis is significantly associated with HPV. The most frequent indications for referral to urological clinic among HPV-positive males were other, non-HPV-related conditions. The HPV prevalence rate of 27% among these patients warrants them to be considered as another risk group for genital HPV infections.